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Breaking Bad News. Robert Buckman’s protocol for letting someone know something that they don’t want to hear. Getting Started. Private with Doctor and patient sitting comfortably “How are you feeling right now?” Anyone that the patient would want present?.
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Breaking Bad News Robert Buckman’s protocol for letting someone know something that they don’t want to hear
Getting Started • Private with Doctor and patient sitting comfortably • “How are you feeling right now?” • Anyone that the patient would want present?
Finding out how much the patient knows • Details are important • “What detail would you like to hear?” • Specific or general • Keeps the patient (a person) as the priority • “What have you already been told?”
Sharing the information • Have agenda in mind before sit down • Topics could include: • Diagnosis • Treatment • Prognosis • Support or Coping • Focus will be on one or two • Information should be given in small chunks • Long lectures are overwhelming and confusing • Translate medical terms and avoid teaching pathophysiology
Responding to the patients feelings • Must respond properly • Caring physician • Acknowledge the reaction • Go with reaction • “Could you tell me a bit about what you are feeling?”
Plan follow-through • Outline a step-by-step plan that will be carried out in the patients system of health care • Be explicit about the next contact with the patient • Arrange a means of contact if needed • Probably will (questions/concerns)
